This blog is my public diary of experiences that I've had as I become increasingly involved in the area of Kensington, Pa. I am including experiences that I am having as I sit down, one on one, with homeless people who are dealing with Substance Use Disorder.
All Names have been changed and, occasionally, I share a story using the opposite pronoun (he/she him/her), as an additional way to assure privacy.

Please Know...

As I come to know these fine people, they share with me more of their personal and sensitive stories. Their collective story is what I am trying to share with you as my way of breaking the stereotypical beliefs that exist. "Blog names" have occasionally been given to me by the person whose story I am telling. Names are never their actual names and wherever I can do so, I might use the opposite pronoun (his/her, etc.) just to help increase their privacy.

Monday, June 10, 2019

Any one of
us who has some annoyance about our own bodies, an annoyance that will only
advance with time, understands the idea of "not being ready" to deal
with the issue. Your issue may be an
advancing bothersome knee or hip. It may
be that pain in your side that won't totally go away - but you can live with it
for now.

Eventually,
when the pain associated with the situation gets severe enough, you will be at
the point where you decide that you are ready to deal with it.You go to your doctor and you begin the
process of healing from it.You go
through the minor or major discomforts of the treatments and come out the other
side of the experience saying "I wish I'd gotten that fixed a long time
ago!"

To one
degree or another, we all do that…

Patients
dealing with Substance Use Disorder are no different than us.Your issue may be your hip.His issue is Substance Use Disorder.Your issue may be that lumbar disk.Her issue is Substance Use Disorder.We all play this game with ourselves of not
doing something about our health situation until it 'hurts enough.'

Non-Substance
Use Disorder patients and Substance Use Disorder patients all do this because
we are all human beings who need to 'hurt enough' to do something about our
unwanted situation.

Each
person's measurement of what "hurts enough" to take action on the
situation varies.Different people can
tolerate higher levels of pain.The
"The Pain Scale Chart" serves patients and clinical service providers
nicely because it takes into account an individual's ability to tolerate their
personal pain.

Here's a
look at that chart:

Substance
Use Disorder patients who call that piece of sidewalk on Kensington Avenue
'home' are equally human with Non-Substance Use Disorder persons who live in
big fancy homes.[1]Their tendency to wait until their situation
'hurts enough' is no different than ours.Except for those who have overdosed and died, when they are 'ready' they
seek help.[2]

Almost every
Substance Use Disorder patient on the streets of Kensington is reliant on
Medicaid to cover their medical expenses.There is the rare but occasional exception of the young person who is
still on their parent's insurance or the military service veteran who does not
realize they have veteran's benefits.

In this "Simple Mental Health Pain Scale"
that can be found at this
website, at level 10, the patient is urged to "contact a crisis line
immediately."

Substance Use
Disorder patients of the streets of Kensington are required to go to the local
crisis center for services once they've decided they are 'ready.'

When the Medicaid reliant Substance Use Disorder patient reaches that point where they are 'ready' for treatment, the system, as it stands now, does not meet them in their present state of readiness - a mental place for this person that must be met immediately so as not to lose this life saving 'window of opportunity.'

Here's what
I wrote last December as I compared the Medicaid system of health care for
Substance Use Disorder patients with the private insurance side of the
issue."George and John" are
fictitious brothers.Their experiences
are all experiences that I have had with real people during the past 2.5 years.

**********

On the Day that George and John were born,
their parents, in a fog of addiction, gave them up at local safe drop off
stations, George on one day at one such station and John on another day at
another station.As fraternal twins,
they looked nothing alike.They bore no
identical traits other than the propensity for addiction that lingered quietly
within them.

George and
John were placed in loving homes through adoption.

George's
home was one of considerable financial wellbeing, mostly through his parent's
many real estate holdings.George went
to the finest schools as a child.In
2008, finances dried up for George's family and times got tough.His Dad and Mom moved their family of three
into the basement of a family friend who had a dark side.This friend introduced George to aspects of
life that no child should ever know.The
resulting pain and confusion within the soul of George awakened the inner demon
of addiction.Heroin became his only and
best friend.

John was
adopted into a hard-working family.Mom
and Dad were both tradespeople.Dad was
a plumber and Mom an electrician.Mom
and Dad loved athletics and as John grew, they encouraged him to find a sport
that he enjoyed.John was awesome at
high school baseball.On one fateful
day, he slid into third base and shattered his leg.Surgeries lasted for months.During this time, to manage his pain, John
was put on opioid-based pain relievers which handled his pain and awakened his
inner demon of addiction.In time,
heroin became his only and best friend

Twins
separated at or near birth and who know nothing of each other have been shown
to often do the same things throughout their separated lives.George and John are examples of this
phenomenon.

On the same
exact day toward the end of 2018, George and John made the same decision...

George woke
up in his tent in a "homeless people's encampment."He glanced over at his tent mate, a young
lady in her twenties.She lay there blue
and lifeless with a noticeable facial injury, the result of a date gone bad
just hours before.This, combined with
other recent street deaths of friends by overdose, pneumonia and one out of
control car and his own multiple overdoses saved by Narcan in recent months
watered a seed of rational thinking that had laid dormant for years within
George.

John lived
with his addiction and his family and kept distant from them but not from it in
his basement apartment.He began to
realize that life was not going in the direction it needed to go.One night, upstairs, around his parent's
kitchen table, John confessed his sadness and self-loathing to his Mom and
Dad.The three of them through a lot of
tears and a tiny bit of yelling decided on a course of action to address John's
addiction.With private insurance cards
in hand, phone calls and arrangements were made for John to enter detox and
rehab.Later that same day, John
injected one last dose of his needed medicine, was picked up by a driver from
his rehab home of the next 28 to 30 days, arrived and was met by men and women
who treated him with the dignity and respect deserving of any human being.

From the
moment John entered the building and on his walk to the admissions office and
then to his detox room, John walked through tastefully decorated halls lined
with portraits of famous strugglers of addiction and inspiring quotes from
people throughout the decades.He could
not help but notice the brightly lit lounge areas with their electronic
fireplaces and large screen TVs.Under
his shoed feet, every step of the way, he walked on well maintained simulated
hardwood floors.

George knew
what he needed to do to enter detox.For
the next few days, as he continued his normal routine of living in a tent and
'flying a sign' at street corners that read "Hungry," George connived
to survive and hustled to pull together an extra $60.00 so as to buy extra dope
to hide on him during his expected one day wait in the Crisis Center several
blocks away.

With enough
money in hand, he bought the extra dope, and then walked to the Crisis Center,
pushed the button on the brick wall next to the secured ill painted metal door
with the wire laced security window located in the middle of its upper half.After a couple pushes of the button, a
security guard opened the door and asked why he was there.After explanations, the guard told George to
come in and strip down in public to one layer of outer clothing, to empty all
of his pockets, remove his shoes, allow himself to be frisked and to walk
through a metal detector.With growing
fear and trepidation and a fading determination in his heart, George
complied.With socked feet, he walked
across the worn and tattered simulated hardwood floors that ran throughout the
facility to the awaiting receptionist; was handed a clipboard with papers to be
filled out and told to "Sit over there and fill these out."Once filled out, he handed the papers back
along with his Medicaid insurance card.

As George
sat down, he glanced around the room of grey chairs each attached to the one
next to it.Three other people were in
some stage of being processed.All were
asleep.One was a woman whose 'one layer
of outer clothing' had obviously been her only clothing for quite some
time.A man, asleep and draped across
two chairs and covered with a blanket, lay motionless representing the hours of
waiting he had endured thus far.The
other waiting room resident and only Caucasian of the three looked suspiciously
familiar to George.As George looked at
him, asleep in his chair, he wondered if this was the same man he's seen in a
recent "Has anyone seen my son?" flyer posted up and down the avenue.

One urine
sample, one medical exam, one interview and six hours of room observation later,
George was starting to experience dope sickness and needed to use the
bathroom.From observing, he knew that
anyone who asked to be allowed into the locked bathroom would be checked on
after a very short period of time.George knew that he could not, during that short interval of privacy,
prepare and inject the dope that he had smuggled in and stored on him where
nothing to be consumed should ever be stored.

With an
onset of diarrhea from dope sickness nearly guaranteed any minute, George
requested to use the only bathroom.He
entered it and saw one toilet and two urinals against one wall none of which
had any hint of current privacy provided except for the small holes in the wall
that suggested that privacy enclosures once existed.All pipes typical of bathroom fixtures were
boxed in so as not to be used in combination with one's belt for the purposes
of hanging and ending the misery.But
what did that matter?By requirement,
George had surrendered his belt hours ago.

It was more
than George could take.He walked out of
the bathroom without feeling better, politely told the nurse that he was
leaving, was reintroduced to his belongings, left and found a back alley nearby
to use as his bathroom.

John's road
to recovery is well underway.

George is
living in a tent.

The one
thing both facilities have in common:Simulated Hardwood Floors.

[1] And
don't think for a moment that there are no formerly fancy -homed people now on
that sidewalk!

[2] While
it goes beyond the point of this blog entry, it should be pointed out briefly
that the ability of the Substance Use Disorder patient to rationally determine their
'readiness' is hampered by many factors of overwhelming non-rational thought
processes.